Opinion
No. 05-15-00005-CV
01-07-2016
VELDA PHILLIPS, Appellant v. DR. RYAN F. JONES AND MEDICAL CLINIC OF NORTH TEXAS, PLLC, Appellees
On Appeal from the 95th Judicial District Court Dallas County, Texas
Trial Court Cause No. DC-14-03900
MEMORANDUM OPINION
Before Justices Lang-Miers, Evans, and Schenck
Opinion by Justice Lang-Miers
In this appeal we are asked to determine whether the claim filed by Velda Phillips against Dr. Ryan F. Jones and Medical Clinic of North Texas, PLLC is a health care liability claim. The trial court concluded that it was and granted appellees' motion to dismiss for failure to file an expert report pursuant to Chapter 74 of the Texas Civil Practice and Remedies Code. For the reasons that follow, we affirm the trial court's order.
Background
Phillips went to see Dr. Jones at the Clinic for a medical examination. After the examination was completed and Dr. Jones had left the examination room, Phillips stepped down from the examination table, slipped, and fell off the step. Phillips sued Dr. Jones and the Clinic for injuries she sustained when she fell. She alleged that she "was an invitee" at the Clinic and went to the Clinic "seeking medical services"; that she "slipped and fell off of the step next to the examining table in the office of Dr. Ryan Jones, injuring her toes on both feet and her upper back"; that Dr. Jones and the Clinic "knew or should have known that the condition on its premises created an unreasonable risk of harm to invitees in that [they] knew the step next to the examining table could cause injury"; that Dr. Jones and the Clinic "knew this condition causes an unreasonable risk of harm to customers such as [her] who would use the step next to the examining table"; that appellees failed to exercise ordinary care, failed to reduce or eliminate the risk, and failed to warn invitees about the risk "that the step had a substance on it or would cause [her] to fall"; and that appellees failed to properly inspect the premises and warn her that she should "use extra care when stepping down."
Phillips did not file an expert report within the statutory deadline for a health care liability claim, and Dr. Jones and the Clinic moved to dismiss her claim. After a hearing, the trial court granted the motion to dismiss and Phillips appealed.
Phillips contends that her lawsuit is not a health care liability claim and she was not required to file an expert report. She argues that her claim "is not based upon any medical care provided or not provided by the Appellees" and that it is not "based upon any departure from accepted standards of medical care directly related to healthcare provided to [her] by the Appellees." Instead, she contends that her claim is one of ordinary negligence and that the standard of care owed to her is the duty of care a business owes to an invitee "to keep the premises in a reasonably safe condition, inspect the premises to discover latent defects, and to make safe any defects or give an adequate warning of dangers."
Dr. Jones and the Clinic contend that Phillips's lawsuit is a health care liability claim because it alleges a departure from accepted standards of safety related to health care and must be dismissed because Phillips did not file an expert report within the statutory deadline.
Discussion
Whether a claim is a health care liability claim is a question of law that we review de novo. Ross v. St. Luke's Episcopal Hosp., 462 S.W.3d 496, 501 (Tex. 2015). Chapter 74 of the Texas Civil Practice and Remedies Code defines "health care liability claim" as
a cause of action against a health care provider for treatment, lack of treatment, or other claimed departure from accepted standards of medical care, or health care, or safety or professional or administrative services directly related to health care, which proximately results in injury to or death of a claimant, whether the claimant's claim or cause of action sounds in tort or contract.TEX. CIV. PRAC. & REM. CODE ANN. § 74.001(13) (West Supp. 2015) (emphasis added). If a claim is a health care liability claim, the claimant must serve one or more expert reports in compliance with the statute or risk having her claim dismissed. Id. § 74.351.
When a claim against a health care provider alleges a departure from safety standards, it is a health care liability claim only if there is a "substantive nexus between the safety standards allegedly violated and the provision of health care." Ross, 462 S.W.3d at 504. The "nexus must be more than a 'but for' relationship." Id. "The pivotal issue . . . is whether the standards on which the claim is based implicate the defendant's duties as a health care provider, including its duties to provide for patient safety." Id. at 505. The following non-exclusive factors are considerations in making that determination:
1. Did the alleged negligence of the defendant occur in the course of the defendant's performing tasks with the purpose of protecting patients from harm;
2. Did the injuries occur in a place where patients might be during the time they were receiving care, so that the obligation of the provider to protect persons who require special, medical care was implicated;
3. At the time of the injury was the claimant in the process of seeking or receiving health care;
4. At the time of the injury was the claimant providing or assisting in providing health care;
5. Is the alleged negligence based on safety standards arising from professional duties owed by the health care provider;
6. If an instrumentality was involved in the defendant's alleged negligence, was it a type used in providing health care; orId.
7. Did the alleged negligence occur in the course of the defendant's taking action or failing to take action necessary to comply with safety-related requirements set for health care providers by governmental or accrediting agencies?
Phillips did not address these factors in her opening appellate brief because the Ross opinion was issued after she filed her brief. However, Phillips addressed the factors in her reply brief and contends that they do not support the trial court's finding that her claim is a health care liability claim. She contends that Dr. Jones and the Clinic had an obligation "to provide a safe environment accessible by the public rather than as a physician providing for patient safety." We disagree.
A physician's examination room is not a room "accessible by the public." Instead, it is a room accessible by the physician, staff, and patients. The physician uses the examination room to examine patients who have sought the physician's medical services. Phillips argues that "it is noteworthy that [her examination] was completed" when "she slipped and fell off of the step next to the examination table" because she was no longer receiving or seeking medical services. Again, we disagree. The examination table, along with the step used for getting on and off the table, is "an instrumentality" integral to the rendition of medical services in a physician's examination room. See id. (factor 6). And "an accepted standard of safety is implicated . . . when the unsafe condition or thing, causing injury to the patient, is an inseparable or integral part of the patient's care or treatment." See Marks v. St. Luke's Episcopal Hosp., 319 S.W.3d 658, 664 (Tex. 2010) (plurality op.) (claim for injury sustained when patient fell while trying to use footboard on hospital bed to push himself from bed to standing position is health care liability claim). We conclude that an injury occurring in a health care provider's examination room on equipment typically used in providing health care implicates the health care provider's obligation to provide a safe environment for patients. See id. (factors 1, 2, 3, 5, 6).
Phillips cites several cases to support her contention that her claim is not a health care liability claim. See, e.g., Methodist Hosps. of Dallas v. Garcia, No. 05-13-01307-CV, 2014 WL 2003121, at *1 (Tex. App.—Dallas May 14, 2014, no pet.) (mem. op.) (claim that hospital visitor injured when elevator fell from second floor to first floor not health care liability claim); Columbia Med. Ctr. of Denton Subsidiary, LP v. Braudrick, No. 02-13-00399-CV, 2014 WL 2144877, at *1 (Tex. App.—Fort Worth May 11, 2014, pet. denied) (claim that person stepped in hole and fell while walking on median in hospital parking lot not health care liability claim); Methodist HealthCare System v. Dewey, 423 S.W.3d 516, 510 (Tex. App.—San Antonio 2014, pet. denied) (claim that hospital visitor slipped and fell on floor while entering hospital not a health care liability claim); Weatherford Tex. Hosp. Co. v. Smart, 423 S.W.3d 462, 467-68 (Tex. App.—Fort Worth 2014, pet. denied) (claim that hospital visitor slipped and fell in lobby not a health care liability claim); Christus St. Elizabeth Hosp. v. Guillory, 415 S.W.3d 900, 900-01 (Tex. App.—Beaumont 2013, pet. denied) (claim that hospital visitor slipped and fell on substance on floor in hallway not a health care liability claim). But those cases involved persons who were not seeking medical care at the facility where they were injured, and the injuries were wholly unrelated to the rendition of health care. As a result, those cases do not apply to the circumstances of this case.
Here, Phillips was a patient seeking medical care from Dr. Jones at the Clinic when she slipped and fell off a step next to an examination table in the Clinic's examination room. Cf. Ross, 462 S.W.3d at 505. Having considered Phillips's allegations in light of the non-exclusive Ross factors, we conclude that the "substantive nexus" is satisfied in this case and that Phillips's claim is a health care liability claim. See id. at 504-05. As a result, Phillips was required to file an expert report in compliance with Chapter 74 and, because she did not, the trial court did not err by granting appellees' motion to dismiss. We affirm the trial court's order.
/Elizabeth Lang-Miers/
ELIZABETH LANG-MIERS
JUSTICE 150005F.P05
JUDGMENT
On Appeal from the 95th Judicial District Court, Dallas County, Texas
Trial Court Cause No. DC-14-03900.
Opinion delivered by Justice Lang-Miers, Justices Evans and Schenck participating.
In accordance with this Court's opinion of this date, the judgment of the trial court is AFFIRMED.
It is ORDERED that appellees Dr. Ryan F. Jones and Medical Clinic of North Texas, PLLC recover their costs of this appeal from appellant Velda Phillips.